Services

Time wasters at East Lancashire's urgent care centres told to see GPs

A THIRD of patients seeking help at Blackburn’s Urgent Care Centre could be sent to their GP or pharmacy after research found many attendees should not be there.

The changes follow an audit of attendance at Royal Blackburn Hospital and Burnley General Hospital’s UCCs which found that up to 50 patients a day did not need hospital treatment.

The scheme is being run for a six-month trial at Blackburn and if it is found to be successful, will be rolled out to Burnley.

Each patient who visits the UCC costs the NHS a minimum of £54, even if they do not receive any treatment, leading the NHS in East Lancashire to overspend £7million on unplanned care last year.

From today, residents who go to the centre unnecessarily will be redirected back to another health professional such as their GP, pharmacist or dentist, or given advice about how to look after themselves.

Patients will be assessed on arrival by a senior nurse using a computer system that helps determine how urgent a request for clinician attention is and what priority to assign to them.

Dr Charles Thomson, ELHT Emergency Department Consultant, said: “Patients may think that hospital is the best place for them, but that is not always the case. Urgent Care Services need to be reserved for urgent illnesses and injuries that cannot be treated elsewhere.

“We had one patient who attended 40 times with the same symptoms, which didn’t need treatment.

“And another who visited nine times in a single week with four different complaints and left before treatment.

“In both cases, these patients could have received assessment and reassurance from their GP or the NHS 111 helpline.”

The scheme has been jointly developed by ELHT and both the East Lancashire and Blackburn with Darwen Clinical Commissioning Groups.

Dr David White, a Burnley GP, said: “This is not about making savings, but about spending wisely and making sure vital resources are available for those who need them most, while at the same time making sure all patients get the treatment they need in the right place.”

Comments

That rich !!! It can take several days to see my doctor, unless I am the lucky one to be first in when they switch the phones on at 8 am. Three minutes later and all appointments are gone.

That rich !!! It can take several days to see my doctor, unless I am the lucky one to be first in when they switch the phones on at 8 am. Three minutes later and all appointments are gone.burner

That rich !!! It can take several days to see my doctor, unless I am the lucky one to be first in when they switch the phones on at 8 am. Three minutes later and all appointments are gone.

Score: 0

Bess1e
11:22am Mon 28 Jan 13

Patients don't always know whether their symptoms are serious or not - after all, if they did, they'd be working at the hospital! Bad indigestion can often be mistaken for a heart attack. I know that all NHS facilities need to maximise their efficiency but asking patients to self-diagnose is very risky, imho.

Patients don't always know whether their symptoms are serious or not - after all, if they did, they'd be working at the hospital! Bad indigestion can often be mistaken for a heart attack. I know that all NHS facilities need to maximise their efficiency but asking patients to self-diagnose is very risky, imho.Bess1e

Patients don't always know whether their symptoms are serious or not - after all, if they did, they'd be working at the hospital! Bad indigestion can often be mistaken for a heart attack. I know that all NHS facilities need to maximise their efficiency but asking patients to self-diagnose is very risky, imho.

Score: 0

BRFC195
12:23pm Mon 28 Jan 13

the telegraph are also reporting a case today of meningistis to which a life was lost it was reposted in his story that he visited a chemist and was told it was flu to which his wifes condition resulted in her dying .

the telegraph are also reporting a case today of meningistis to which a life was lost it was reposted in his story that he visited a chemist and was told it was flu to which his wifes condition resulted in her dying .BRFC195

the telegraph are also reporting a case today of meningistis to which a life was lost it was reposted in his story that he visited a chemist and was told it was flu to which his wifes condition resulted in her dying .

Score: 0

jimpy0
1:19pm Mon 28 Jan 13

If your GP is oversubscribed then xchange him/her, there are many that operate a no wait system just turn up on the day.

If your GP is oversubscribed then xchange him/her, there are many that operate a no wait system just turn up on the day.jimpy0

If your GP is oversubscribed then xchange him/her, there are many that operate a no wait system just turn up on the day.

Score: 0

Shirley Bassey
1:56pm Mon 28 Jan 13

There's also the NHS 111 number - they give you advice about where to go if you're not sure so you don't have to worry about diagnosing yourself and getting it wrong.

There's also the NHS 111 number - they give you advice about where to go if you're not sure so you don't have to worry about diagnosing yourself and getting it wrong.Shirley Bassey

There's also the NHS 111 number - they give you advice about where to go if you're not sure so you don't have to worry about diagnosing yourself and getting it wrong.

Score: 0

Pinky&theBrain
3:13pm Mon 28 Jan 13

What a farce, this hospital is appalling, death rates the 5th highest in the country, mis diagnosis of meningitis by a pharmacist just this week, and a GP service that has so little access it beggars belief. When you need to be seen by your GP you have to call 2 weeks in advance and plan your illness. How do the 'senior nurses' think they're going to get you in to a GP who is already booked up, or out on visits.This whole health care system is on a path to financial ruin, and right at the centre is a hospital that can't keep people alive, use Locums and agency staff as the normal way of filling vacancies because no-one wants to work for them, and now have decided the best way to solve their problems is turn people away. GPs think they are running the show? I say it's the hospital that is running away with the health budget so they can fund the staffing budget - and they should be suffering - not patients.

What a farce, this hospital is appalling, death rates the 5th highest in the country, mis diagnosis of meningitis by a pharmacist just this week, and a GP service that has so little access it beggars belief. When you need to be seen by your GP you have to call 2 weeks in advance and plan your illness. How do the 'senior nurses' think they're going to get you in to a GP who is already booked up, or out on visits.This whole health care system is on a path to financial ruin, and right at the centre is a hospital that can't keep people alive, use Locums and agency staff as the normal way of filling vacancies because no-one wants to work for them, and now have decided the best way to solve their problems is turn people away. GPs think they are running the show? I say it's the hospital that is running away with the health budget so they can fund the staffing budget - and they should be suffering - not patients.Pinky&theBrain

What a farce, this hospital is appalling, death rates the 5th highest in the country, mis diagnosis of meningitis by a pharmacist just this week, and a GP service that has so little access it beggars belief. When you need to be seen by your GP you have to call 2 weeks in advance and plan your illness. How do the 'senior nurses' think they're going to get you in to a GP who is already booked up, or out on visits.This whole health care system is on a path to financial ruin, and right at the centre is a hospital that can't keep people alive, use Locums and agency staff as the normal way of filling vacancies because no-one wants to work for them, and now have decided the best way to solve their problems is turn people away. GPs think they are running the show? I say it's the hospital that is running away with the health budget so they can fund the staffing budget - and they should be suffering - not patients.

Score: 0

Fire Fly
10:09pm Mon 28 Jan 13

Common sense at last!

50 patients per day not actually needing to be in the urgent care centre & a batch of repeat offenders.

How much time do these 50 cases take up ? On each of these days, how many times have we had articles about the waiting time in the urgent care centre's & how many times do people comment on here that the waiting time is disgusting?? Now its, people can't be expected to know f they are very ill or not....umm I reckon you could hazard a very good guess in a lot of cases.

This hospital has its issues without question but its about time people stopped overreacting when ill or spitting their dummy out because the GP is busy by heading to A&E with minor illnesses.

Unless people readjust their expectations of the NHS, we wont have one left.

Common sense at last!
50 patients per day not actually needing to be in the urgent care centre & a batch of repeat offenders.
How much time do these 50 cases take up ? On each of these days, how many times have we had articles about the waiting time in the urgent care centre's & how many times do people comment on here that the waiting time is disgusting?? Now its, people can't be expected to know f they are very ill or not....umm I reckon you could hazard a very good guess in a lot of cases.
This hospital has its issues without question but its about time people stopped overreacting when ill or spitting their dummy out because the GP is busy by heading to A&E with minor illnesses.
Unless people readjust their expectations of the NHS, we wont have one left.Fire Fly

Common sense at last!

50 patients per day not actually needing to be in the urgent care centre & a batch of repeat offenders.

How much time do these 50 cases take up ? On each of these days, how many times have we had articles about the waiting time in the urgent care centre's & how many times do people comment on here that the waiting time is disgusting?? Now its, people can't be expected to know f they are very ill or not....umm I reckon you could hazard a very good guess in a lot of cases.

This hospital has its issues without question but its about time people stopped overreacting when ill or spitting their dummy out because the GP is busy by heading to A&E with minor illnesses.

Unless people readjust their expectations of the NHS, we wont have one left.

Score: 0

kate11
7:45am Tue 29 Jan 13

Oh Firefly here you go again defending the hospital while everyone else can see there is a problem with how East Lancs Trust is managed! Pinky&theBrain and Bess1e are spot on! Maybe you should listen to them and actually comment on what they have said rather than telling us your own agenda!! This just shows managers at the hospital do not listen to the staff or the patients !

Oh Firefly here you go again defending the hospital while everyone else can see there is a problem with how East Lancs Trust is managed! Pinky&theBrain and Bess1e are spot on! Maybe you should listen to them and actually comment on what they have said rather than telling us your own agenda!! This just shows managers at the hospital do not listen to the staff or the patients !kate11

Oh Firefly here you go again defending the hospital while everyone else can see there is a problem with how East Lancs Trust is managed! Pinky&theBrain and Bess1e are spot on! Maybe you should listen to them and actually comment on what they have said rather than telling us your own agenda!! This just shows managers at the hospital do not listen to the staff or the patients !

Score: 0

cutthebull
9:40am Tue 29 Jan 13

Fire Fly wrote…

Common sense at last!

50 patients per day not actually needing to be in the urgent care centre & a batch of repeat offenders.

How much time do these 50 cases take up ? On each of these days, how many times have we had articles about the waiting time in the urgent care centre's & how many times do people comment on here that the waiting time is disgusting?? Now its, people can't be expected to know f they are very ill or not....umm I reckon you could hazard a very good guess in a lot of cases.

This hospital has its issues without question but its about time people stopped overreacting when ill or spitting their dummy out because the GP is busy by heading to A&E with minor illnesses.

Unless people readjust their expectations of the NHS, we wont have one left.

Couldn't have said it any better myself! My granddaughter had to wait in urgent care recently for 3hrs with a broken arm & the waiting room was full of people. I overheard several conversations 1 being a fit young lad who had a rash on his arm for 7 months! Why was he there??? His girlfriend was also waiting to see the doctor because she had a runny nose! These two people where infront of my granddaughter so her treatment was being delayed because I would say as a nurse that these two people do not need to be there. In 7 months you've not tried to make an appointment with the gp? Times that by 50 people a day! Kate11 you don't know what your talking about, the NHS is being abused by people, in the 60s my mum always said I had to be dying or my arm dropping off before I saw a doctor. Now people expect to see a doctor for a sniffle? Really is that what the system was designed for? No!. My friend works on A&E & she has took me about people who book in to get paracetamol! They'd rather sit for 4 hrs than pay 20p for a packet because they'll get it for free. I for one welcome any scheme that installs common sense into the public. Also majority of those who abuse the system don't often pay into it!

[quote][p][bold]Fire Fly[/bold] wrote:
Common sense at last!
50 patients per day not actually needing to be in the urgent care centre & a batch of repeat offenders.
How much time do these 50 cases take up ? On each of these days, how many times have we had articles about the waiting time in the urgent care centre's & how many times do people comment on here that the waiting time is disgusting?? Now its, people can't be expected to know f they are very ill or not....umm I reckon you could hazard a very good guess in a lot of cases.
This hospital has its issues without question but its about time people stopped overreacting when ill or spitting their dummy out because the GP is busy by heading to A&E with minor illnesses.
Unless people readjust their expectations of the NHS, we wont have one left.[/p][/quote]Couldn't have said it any better myself! My granddaughter had to wait in urgent care recently for 3hrs with a broken arm & the waiting room was full of people. I overheard several conversations 1 being a fit young lad who had a rash on his arm for 7 months! Why was he there??? His girlfriend was also waiting to see the doctor because she had a runny nose! These two people where infront of my granddaughter so her treatment was being delayed because I would say as a nurse that these two people do not need to be there. In 7 months you've not tried to make an appointment with the gp? Times that by 50 people a day! Kate11 you don't know what your talking about, the NHS is being abused by people, in the 60s my mum always said I had to be dying or my arm dropping off before I saw a doctor. Now people expect to see a doctor for a sniffle? Really is that what the system was designed for? No!. My friend works on A&E & she has took me about people who book in to get paracetamol! They'd rather sit for 4 hrs than pay 20p for a packet because they'll get it for free. I for one welcome any scheme that installs common sense into the public. Also majority of those who abuse the system don't often pay into it!cutthebull

Fire Fly wrote…

Common sense at last!

50 patients per day not actually needing to be in the urgent care centre & a batch of repeat offenders.

How much time do these 50 cases take up ? On each of these days, how many times have we had articles about the waiting time in the urgent care centre's & how many times do people comment on here that the waiting time is disgusting?? Now its, people can't be expected to know f they are very ill or not....umm I reckon you could hazard a very good guess in a lot of cases.

This hospital has its issues without question but its about time people stopped overreacting when ill or spitting their dummy out because the GP is busy by heading to A&E with minor illnesses.

Unless people readjust their expectations of the NHS, we wont have one left.

Couldn't have said it any better myself! My granddaughter had to wait in urgent care recently for 3hrs with a broken arm & the waiting room was full of people. I overheard several conversations 1 being a fit young lad who had a rash on his arm for 7 months! Why was he there??? His girlfriend was also waiting to see the doctor because she had a runny nose! These two people where infront of my granddaughter so her treatment was being delayed because I would say as a nurse that these two people do not need to be there. In 7 months you've not tried to make an appointment with the gp? Times that by 50 people a day! Kate11 you don't know what your talking about, the NHS is being abused by people, in the 60s my mum always said I had to be dying or my arm dropping off before I saw a doctor. Now people expect to see a doctor for a sniffle? Really is that what the system was designed for? No!. My friend works on A&E & she has took me about people who book in to get paracetamol! They'd rather sit for 4 hrs than pay 20p for a packet because they'll get it for free. I for one welcome any scheme that installs common sense into the public. Also majority of those who abuse the system don't often pay into it!

Score: 0

[deleted]
2:38pm Tue 29 Jan 13

[deleted]

With regards to this article, it does not take a genius or an audit to work out that there are patients attending both Urgent Care Centres that could be seen by their GP. This has been going on in ELHT for years now. However, the problem does seem to have got worse over the last few years since some GP practices have introduced the new appointment systems. What we all have to understand is that this is a much bigger problem! In order for this new way of working to have any chance of success it is imperative that all GP practices come on board. This would require a complete overhaul of the current appointments systems so that patients could gain access to their GP as and when required. What we don't want are patients migrating to GP practices that offer more flexibility. This would then shift the problem, and then impact on service provision elsewhere. Basically, this is the last thing that we would want to see. Common sense has to prevail here! Some patients might only initially require a telephone appointment and then access to the Practice Nurse. I have to agree with the point that was made by BRFC195 that we have to be cautious and ensure that we do not misdiagnose and fail to recognise acute conditions whilst teasing out the time wasters!!! We all know who the time wasters are and these should be dealt with separately. However, there are two full time Buisness Managers on Bands 8b and two full time Matrons on Bands 8a who are responsible for overseeing the running of the two Urgent Care Centres, AVH Minor Injuries Unit and the Emergency Department (A&E). To be honest with you these salaries combined total at least £205,000 per year not including unsocial pay enhancements. That is almost a quarter of a million pounds. OUCH!!!! If you look on the Royal College of Nursing (RCN) Agenda for Change (AFC) website you will be able to research these pay scales for yourselves. Why has it taken an external audit to tell them this? As I see it, this is part of their role. What are they paying them for? I have to be fair to say that one of the Buisness Managers (Band 8b) has only been working in the Trust and in the department for a few months now and seems to be making a positive impact and some in roads into putting things right. She has inspired the staff and has made more of a difference in a few months, than her equal has in two years. The other Buisness Manager (Band 8b) has been managing those departments for around 2 years now and to be honest I would not employ her to stick on stamps! What has she been doing to rectify these problems? The answer here is nothing! Anybody reading my comments would know exactly what I mean and who I am talking about. Her department has been failing the 4 hour waiting times targets all winter, yet she is still there drawing her "fat cat" salary. This takes us back to the argument of having the right people in the right jobs. My knowledge of the organisation is very good and I know through experience that the culture for promotion to senior management positions in ELHT runs on "jobs for the boys" and "friends and families". It has nothing to do with the right person for the right job! It is not about "what you know" it is all about "who you know". Hence why the Trust has not achieved Foundation Trust Status yet. Work that one out for yourselves!
Going back to the article, I hope that the two GP's who have made their comments in this article have reviewed and realigned their appointment systems so that their appointments are more easily accessible? This then might encourage other GP practices to follow suit! If they don't, then they should be forced to change by the Department of Health (DOH). After all, the DOH do have the final say.
The front line staff in ELHT want to fix these problems but they can't. They are completely "powerless"!!!Protector

With regards to this article, it does not take a genius or an audit to work out that there are patients attending both Urgent Care Centres that could be seen by their GP. This has been going on in ELHT for years now. However, the problem does seem to have got worse over the last few years since some GP practices have introduced the new appointment systems. What we all have to understand is that this is a much bigger problem! In order for this new way of working to have any chance of success it is imperative that all GP practices come on board. This would require a complete overhaul of the current appointments systems so that patients could gain access to their GP as and when required. What we don't want are patients migrating to GP practices that offer more flexibility. This would then shift the problem, and then impact on service provision elsewhere. Basically, this is the last thing that we would want to see. Common sense has to prevail here! Some patients might only initially require a telephone appointment and then access to the Practice Nurse. I have to agree with the point that was made by BRFC195 that we have to be cautious and ensure that we do not misdiagnose and fail to recognise acute conditions whilst teasing out the time wasters!!! We all know who the time wasters are and these should be dealt with separately. However, there are two full time Buisness Managers on Bands 8b and two full time Matrons on Bands 8a who are responsible for overseeing the running of the two Urgent Care Centres, AVH Minor Injuries Unit and the Emergency Department (A&E). To be honest with you these salaries combined total at least £205,000 per year not including unsocial pay enhancements. That is almost a quarter of a million pounds. OUCH!!!! If you look on the Royal College of Nursing (RCN) Agenda for Change (AFC) website you will be able to research these pay scales for yourselves. Why has it taken an external audit to tell them this? As I see it, this is part of their role. What are they paying them for? I have to be fair to say that one of the Buisness Managers (Band 8b) has only been working in the Trust and in the department for a few months now and seems to be making a positive impact and some in roads into putting things right. She has inspired the staff and has made more of a difference in a few months, than her equal has in two years. The other Buisness Manager (Band 8b) has been managing those departments for around 2 years now and to be honest I would not employ her to stick on stamps! What has she been doing to rectify these problems? The answer here is nothing! Anybody reading my comments would know exactly what I mean and who I am talking about. Her department has been failing the 4 hour waiting times targets all winter, yet she is still there drawing her "fat cat" salary. This takes us back to the argument of having the right people in the right jobs. My knowledge of the organisation is very good and I know through experience that the culture for promotion to senior management positions in ELHT runs on "jobs for the boys" and "friends and families". It has nothing to do with the right person for the right job! It is not about "what you know" it is all about "who you know". Hence why the Trust has not achieved Foundation Trust Status yet. Work that one out for yourselves!

Going back to the article, I hope that the two GP's who have made their comments in this article have reviewed and realigned their appointment systems so that their appointments are more easily accessible? This then might encourage other GP practices to follow suit! If they don't, then they should be forced to change by the Department of Health (DOH). After all, the DOH do have the final say.

The front line staff in ELHT want to fix these problems but they can't. They are completely "powerless"!!!

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